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Duration of Dual Antiplatelet Therapy After Implantation of Drug-Coated Balloon
Frontiers in Cardiovascular Medicine ( IF 2.8 ) Pub Date : 2021-12-01 , DOI: 10.3389/fcvm.2021.762391
Yuxuan Zhang 1 , Xinyi Zhang 1 , Qichao Dong 1 , Delong Chen 1 , Yi Xu 2 , Jun Jiang 1
Affiliation  

The drug-coated balloon (DCB) is an emerging percutaneous coronary intervention (PCI) device with theoretical advantages and promising results. Recent clinical observations have demonstrated that DCB tends to have both good efficacy and a good safety profile in the treatment of in-stent restenosis (ISR) for both bare-metal and drug-eluting stents (DES), de novo coronary artery disease (CAD), and other situation, such as high bleeding risk, chronic total occlusion, and acute coronary syndrome (ACS). Dual antiplatelet therapy (DAPT) has become an essential medication in daily clinical practice, but the optimal duration of DAPT after the implantation of a DCB remains unknown. At the time of the first in vivo implantation of paclitaxel-DCB for the treatment of ISR in 2006, the protocol-defined DAPT duration was only 1 month. Subsequently, DAPT duration ranging from 1 to 12 months has been recommended by various trials. However, there have been no randomized controlled trials (RCTs) on the optimal duration of DAPT after DCB angioplasty. Current clinical guidelines normally recommend the duration of DAPT after DCB-only angioplasty based on data from RCTs on the optimal duration of DAPT after stenting. In this review, we summarized current clinical trials on DCB-only angioplasty for different types of CADs and their stipulated durations of DAPT, and compared their clinical results such as restenosis, target lesion revascularization (TLR) and stent thrombosis event. We hope this review can assist clinicians in making reasonable decisions about the duration of DAPT after DCB implantation.



中文翻译:

药物涂层球囊植入后双重抗血小板治疗的持续时间

药物涂层球囊(DCB)是一种新兴的经皮冠状动脉介入治疗(PCI)装置,具有理论优势和可喜的成果。最近的临床观察表明,DCB 在治疗裸金属支架和药物洗脱支架 (DES) 的支架内再狭窄 (ISR) 方面往往具有良好的疗效和良好的安全性,从头开始冠状动脉疾病 (CAD) 和其他情况,如高出血风险、慢性完全闭塞和急性冠状动脉综合征 (ACS)。双联抗血小板治疗 (DAPT) 已成为日常临床实践中必不可少的药物,但植入 DCB 后 DAPT 的最佳持续时间仍然未知。第一次的时候体内2006 年植入紫杉醇-DCB 治疗 ISR,协议定义的 DAPT 持续时间仅为 1 个月。随后,各种试验推荐了 1 至 12 个月的 DAPT 持续时间。然而,没有关于 DCB 血管成形术后 DAPT 最佳持续时间的随机对照试验 (RCT)。当前的临床指南通常根据 RCT 中关于支架植入后 DAPT 最佳持续时间的数据,推荐仅 DCB 血管成形术后 DAPT 的持续时间。在这篇综述中,我们总结了目前针对不同类型 CAD 的仅 DCB 血管成形术的临床试验及其规定的 DAPT 持续时间,并比较了它们的临床结果,例如再狭窄、靶病变血运重建 (TLR) 和支架血栓形成事件。

更新日期:2021-12-01
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